How Do I Know if it's Dementia?

One of the most frequent questions I get about dementia, is, "How does it differ from regular forgetfulness?"  I'll explain from my own personal experience below, since my mother suffers from both Alzheimer's Disease (diabetes of the brain) and Vascular Dementia (stroke).

In the beginning stages, it's hard to tell if it's age-related forgetfulness.  We all forget why we walk into a room.  We all have had a word sitting on the tip of our tongue, and can't get it to come out.  We all forget someone's name or forget where we put something for safe-keeping.

In dementia, a person will walk into their own bedroom and not recognize it.  They will wonder why it's messy, but it's their mess.  They will not recognize they have been in that bedroom for years.  They may insist they have never been in the house they live in and want to go home.

In dementia, they don't just have a word lost on the tip of their tongue.  If they are bilingual, they may completely forget how to say it in their second language, and only know it in their primary language.  They may have a word they should know easily, like the name of their spouse, or their children's names, but can't speak it.

They don't just lose things.  They lose things frequently and in weird places.  They lose things because they hid it, such as hiding their cash in a shoe, and then placing their shoe in the garbage can.  They lose things because they inappropriately put things away, such as storing their leftover lunch under their bed, or putting their toothbrush in their sock drawer, and their mail in the oven.  

When they get upset, they may fidget or continuously open and close drawers, cabinets and closets.  They are looking for something, but don't know what they are looking for.  When they finally decide what they are looking for, they may mention something that nobody has ever seen and become accusatory, like a vintage polaroid camera they put on the top shelf of their cabinet, and swear someone stole it, but it never existed to your knowledge.  They may even say the most trusted person you know is a thief.

They begin to say or do inappropriate things at inappropriate times, such as call their doctor ugly, or a pregnant woman a fatty, call their children derogatory names.  They may even become hypersexualized, such as soliciting sex or throwing out innuendoes, even groping someone, or getting naked in public, sometimes with their own family members.

They stop behaving the way they used to, such as the clothing they pick out isn't what you're used to seeing them in.  A woman may have messy make-up and hair.  Hygiene becomes bad.  Shoes are on the wrong feet.  Socks don't match.  Elastic-waisted pants are on backward.  Teeshirts and sweaters are inside out.  Home is becoming hoarder mess of useless stuff, piles of mail, trash piles, clothing piles, rotting fruit on tables, fruit flies and other vermin.  

They try to convince you why some of the things they do makes sense, for instance, my mom used to have an abundance of baby powder from the dollar store and pour it all over herself, into her bed, on the floor, and swore it kept the heat out of the house.  

My mom also constantly obsessed over what other people were doing.  If I brought a friend over, that friend was accused of being promiscuous.  If my husband went to work and was working overtime, my mom said he took my money and went to the casino.  If I brushed it off, she would get hysterical and obsess over it, trying to convince me that I need to believe her, rather than just let it go.  

In dementia, the appetite changes.  They may dislike food they normally loved.  They may like food, they normally hated.  They may eat only bits and pieces.  And, when they get hungry again, they can swear they hadn't eaten all day, though they had breakfast and lunch.

In dementia, they are a fall risk.  People fall sometimes, but in dementia, it's more frequent.  Not only do they have these falling accidents, they have accidents in other ways, such as burning food, dropping things, spilling drinks, car accidents, or knocking things over.  

In communication, toward a more advanced state, they don't follow a conversation very well.  They may nod and agree, but will pick a word out of your entire conversation that they understood and then say something that makes you realize they weren't listening at all.  For example, I could tell my mom, "Today, at work, I had a pregnant client, and she is due in 3 weeks."  My mom would hear the word pregnant, and ask me, "You're pregnant?"  Or, she would hear the word work, and ask me, "Are you going to work?"  She didn't follow the conversation at all.  So, anyone who knows someone with dementia, will have conversations where they frustratingly have to repeat themselves to communicate a story, or even just to give instructions.  

Instructions are difficult for a dementia patient.  They can't remember the order of things.  You can tell someone to get a pot, put water in it, put it on the stove, and turn the stove on, and wait for the water to boil.  They may only hear the word water, and just let the sink run.

My mom never hit me to discipline me as a child.  But while caregiving, she has had tantrums and bit and kicked me, or threatened to throw ceramic coffee mugs across the room.  She has had screaming fits.

In dementia, my mom has become schizophrenic and hallucinatory.  She has seen things that nobody else can see.  She swears someone was there, but there's nobody there.  She has talked to the ceiling, walls, and even her pillow.  The psychosis is scary.  She was not like this before dementia.

So, these were examples of what Dementia looks like from regular "Forgetfulness."